This proposal describes in detail a plan to expand the activities of the Boston University Multipurpose Arthritis Center. Selected programs begun but not completed during the first three years of MAC funding will be continued, and new efforts will be developed in the areas of education, community programs and health services research and evaluation. MAC education efforts will continue to be aimed at a broad spectrum of arthritis health professionals in conjunction with the Schools of Medicine, Nursing, and Allied Health professions of Boston University. Community programs of the MAC will continue to focus on the inner-city community in conjunction with the Department of Health and Hospitals of the City of Boston. Major projects in education will include the establishment and the evaluation of longitudinal arthritis electives for medical house staff and students. Nursing education efforts will continue with a new focus on in-service education for nursing home staff. An annual sociomedical seminar on rheumatoid arthritis and a home visit program, both aimed at medical students, will be strengthened. A major new community program will focus on arthritis in nursing homes. A study to explore the effect of formal patient-provider contracts on compliance will be designed and conducted. In addition to these efforts in education and community programs, a full program of basic and clinical research will continue through other funding mechanisms. Two Core Units will be established. The first will intergrate the numerous studies of amyloid currently being conducted at B.U. The second will establish an evaluation support core for all programs within the Center and for selected projects outside the Center. Two Developmental and Feasibility Studies are described which are designed to support new and productive interactions with other departments. A formal administrative structure and a modest Enrichment Program which centers on a Visiting Professor program are described.